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https://www.readbyqxmd.com/read/29453520/evaluation-of-a-comprehensive-oral-health-services-program-in-school-based-health-centers
#1
Tara Trudnak Fowler, Gregory Matthews, Cydny Black, Hendi Crosby Kowal, Pamella Vodicka, Elizabeth Edgerton
Objectives In 2011, the Maternal and Child Health Bureau, within the Health Resources and Services Administration, awarded a 4-year grant to increase access to and assure the delivery of quality oral health preventive and restorative services to children. The grant was awarded to organizations serving high-need communities through school-based health centers (SBHCs). This article describes an independent evaluation investigating program efficacy, integration, and sustainability. Methods Program process and outcomes data were gathered from interim and final reports...
February 16, 2018: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29452563/code-red-the-essential-yet-neglected-role-of-emergency-care-in-health-law-reform
#2
Shaun Ossei-Owusu
The United States' health care system is mired in uncertainty. Public opinion on the Patient Protection and Affordable Care Act ("ACA") is undeniably mixed and politicized. The individual mandate, tax subsidies, and Medicaid expansion dominate the discussion. This Article argues that the ACA and reform discourse have given short shrift to a more static problem: the law of emergency care. The Emergency Medical Treatment and Active Labor Act of 1986 ("EMTALA") requires most hospitals to screen patients for emergency medical conditions and provide stabilizing treatment regardless of patients' insurance status or ability to pay...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29451142/cost-analysis-of-cervical-cancer-patients-with-different-medical-payment-modes-based-on-gamma-model-within-a-grade-a-tertiary-hospital
#3
Suo-Wei Wu, Tong Chen, Qi Pan, Liang-Yu Wei, Qin Wang, Jing-Chen Song, Chao Li, Ji Luo
Background: Cervical cancer shows a growing incidence and medical cost in recent years that has increased severe financial pressure on patients and medical insurance institutions. This study aimed to investigate the medical economic characteristics of cervical cancer patients with different payment modes within a Grade A tertiary hospital to provide evidence and suggestions for inpatient cost control and to verify the application of Gamma model in medical cost analysis. Methods: The basic and cost information of cervical cancer cases within a Grade A tertiary hospital in the year 2011-2016 were collected...
February 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29450752/racial-and-socioeconomic-differences-in-the-use-of-high-volume-commission-on-cancer-accredited-hospitals-for-cancer-surgery-in-the-united-states
#4
Nabil Wasif, David Etzioni, Elizabeth B Habermann, Amit Mathur, Barbara A Pockaj, Richard J Gray, Yu-Hui Chang
BACKGROUND: Although major cancer surgery at a high-volume hospital is associated with lower postoperative mortality, the use of such hospitals may not be equally distributed. OBJECTIVE: Our aim was to study socioeconomic and racial differences in cancer surgery at Commission on Cancer (CoC)-accredited high-volume hospitals. METHODS: The National Cancer Database (NCDB) was used to identify patients undergoing surgery for colon, esophageal, liver, and pancreatic cancer from 2003 to 2012...
February 15, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29449123/early-impact-of-medicaid-expansion-and-quality-of-breast-cancer-care-in-kentucky
#5
Nicolas Ajkay, Neal Bhutiani, Bin Huang, Quan Chen, Jeffrey D Howard, Thomas C Tucker, Charles R Scoggins, Kelly M McMasters, Hiram C Polk
BACKGROUND: In January 2014, Kentucky expanded Medicaid coverage to include all individuals and families with incomes up to 33% above the federal poverty line. This study evaluated the early impact of Medicaid expansion on some aspects of the quality of breast cancer care in Kentucky. STUDY DESIGN: The Kentucky Cancer Registry was queried for all women aged 20 to 64 years diagnosed with breast cancer between 2011 and 2016. Demographic, tumor, and treatment characteristics were assessed for each year during this interval...
February 10, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29445721/young-adults-selection-and-use-of-dependent-coverage-under-the-affordable-care-act
#6
Weiwei Chen
The dependent coverage expansion under the Affordable Care Act (ACA) required health insurance policies that cover dependents to offer coverage for policyholder' children up to age 26. It has been well documented that the provision successfully reduced the uninsured rate among the young adults. However, less is known about whether dependent coverage crowded out other insurance types and whether young adults used dependent coverage as a fill-in-the-gap short-term option. Using data from the Survey of Income and Program Participation 2008 Panel, the paper assesses dependent coverage uptake and duration before and after the ACA provision among young adults aged 19-26 versus those aged 27-30...
2018: Frontiers in Public Health
https://www.readbyqxmd.com/read/29445246/the-economic-consequences-of-hospital-admissions
#7
Carlos Dobkin, Amy Finkelstein, Raymond Kluender, Matthew J Notowidigdo
We use an event study approach to examine the economic consequences of hospital admissions for adults in two datasets: survey data from the Health and Retirement Study, and hospitalization data linked to credit reports. For non-elderly adults with health insurance, hospital admissions increase out-of-pocket medical spending, unpaid medical bills and bankruptcy, and reduce earnings, income, access to credit and consumer borrowing. The earnings decline is substantial compared to the out-of-pocket spending increase, and is minimally insured prior to age-eligibility for Social Security Retirement Income...
February 2018: American Economic Review
https://www.readbyqxmd.com/read/29443863/trauma-induced-insurance-instability-variation-in-insurance-coverage-for-patients-who-experience-readmission-after-injury
#8
Charlotte M Rajasingh, Thomas G Weiser, Lisa M Knowlton, Lakshika Tennakoon, David A Spain, Kristan L Staudenmayer
INTRODUCTION: Traumatic injuries result in a significant disruption to patients' lives, including their ability to work, which may place patients at risk of losing insurance coverage. Our objective was to evaluate the impact of injury on insurance status. We hypothesized that trauma patients with ongoing health needs experience changes in coverage. METHODS: We used the Nationwide Readmission Database (2013-2014), a nationally representative sample of readmissions in the United States...
February 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29440156/association-between-social-health-insurance-and-choice-of-hospitals-among-internal-migrants-in-china-a-national-cross-sectional-study
#9
Haiqin Wang, Donglan Zhang, Zhiying Hou, Fei Yan, Zhiyuan Hou
OBJECTIVES: There is a tendency to pursue higher-level hospitalisation services in China, especially for internal migrants. This study aims to investigate the choices of hospitalisation services among internal migrants, and evaluate the association between social health insurance and hospitalisation choices. METHODS: Data were from a 2014 nationally representative cross-sectional sample of internal migrants aged 15-59 years in China. Descriptive analyses were used to perform the distribution of healthcare facility levels for hospitalisation services, and multinomial logistic regression was applied to examine the association between social health insurance and hospitalisation choices...
February 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29438192/changes-in-health-insurance-coverage-associated-with-the-affordable-care-act-among-adults-with-and-without-a-cancer-history-population-based-national-estimates
#10
Amy J Davidoff, Gery P Guy, Xin Hu, Felisa Gonzales, Xuesong Han, Zhiyuan Zheng, Helen Parsons, Donatus U Ekwueme, Ahmedin Jemal
BACKGROUND: The Affordable Care Act (ACA) improved health care coverage accessibility by expanding Medicaid eligibility, creating insurance Marketplaces, and subsidizing premiums. We examine coverage changes associated with ACA implementation, comparing adults with and without a cancer history. METHODS: We included nonelderly adults from the 2012 to 2015 National Health Interview Survey. Using information on state Medicaid policies (2013), expansion decisions (2015), family structure, income, insurance offers, and current coverage, we assigned adults in all 4 years to mutually exclusive eligibility categories including: Medicaid-eligible pre-ACA; expansion eligible for Medicaid; and Marketplace premium subsidy eligible...
March 2018: Medical Care
https://www.readbyqxmd.com/read/29437531/improving-population-health-among-uninsured-patients-with-diabetes
#11
Michele H Talley, Shea Polancich, Jason B Williamson, Jennifer S Frank, William Curry, John F Russell, Cynthia Selleck
Diabetes is a leading cause of morbidity and mortality; prevalence of diabetes is especially high in the southeastern United States among minority populations and those from lower socioeconomic sectors without access to health care services. The purpose of this project was to evaluate the clinical and financial outcomes of a nurse-led, interprofessional collaborative practice model that provides care coordination and transitional care for uninsured patients with diabetes. Data for this study were collected and evaluated from medical records of patients seen at the Providing Access to Health Care (PATH) Clinic between August 1, 2015, through May 30, 2017...
February 13, 2018: Population Health Management
https://www.readbyqxmd.com/read/29437204/early-stage-breast-cancer-and-employment-participation-after-2-years-of-follow-up-a-comparison-with-age-matched-controls
#12
Christine C Ekenga, Maria Pérez, Julie A Margenthaler, Donna B Jeffe
BACKGROUND: Although cancer survivors are more likely to be unemployed than individuals without a cancer history, employment participation after treatment of early-stage breast cancer has not been widely studied to date. The objectives of the current study were to evaluate employment trajectories in a cohort of patients with early-stage breast cancer and age-matched controls from the time of diagnosis to the 2-year follow-up, and identify factors associated with diminished and emerging employment participation...
February 13, 2018: Cancer
https://www.readbyqxmd.com/read/29436303/trends-in-insurance-status-among-patients-diagnosed-with-cancer-before-and-after-implementation-of-the-affordable-care-act
#13
Haley A Moss, Laura J Havrilesky, S Yousuf Zafar, Gita Suneja, Junzo Chino
PURPOSE: The Affordable Care Act (ACA) aimed to increase insurance coverage through key provisions such as expansion of Medicaid eligibility and enforcement of an individual mandate. The objective of this study is to examine the impact of the ACA on insurance rates among patients newly diagnosed with colon, lung, or breast cancer. METHODS: Using the SEER database, patients younger than age 65 years diagnosed with colon, lung, or breast cancer between 2008 and 2014 were identified...
February 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29428057/the-impact-of-hospital-and-patient-factors-on-the-emergency-department-decision-to-admit
#14
Leah S Honigman Warner, Jessica E Galarraga, Ori Litvak, Samuel Davis, Michael Granovsky, Jesse M Pines
BACKGROUND: Substantial variation exists in rates of emergency department (ED) admission. We examine this variation after accounting for local and community characteristics. OBJECTIVES: Elucidate the factors that contribute to admission variation that are amenable to intervention with the goal of reducing variation and health care costs. METHODS: We conducted a retrospective cross-sectional study of 1,412,340 patient encounters across 18 sites from 2012-2013...
February 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29425802/health-changes-in-low-income-men-transitioning-from-a-state-funded-prostate-cancer-program-to-comprehensive-insurance
#15
Jamal A Nabhani, Ruby Kuang, Hui Liu, Lorna Kwan, Mark S Litwin
PURPOSE: To evaluate the effect of transitioning from a prostate cancer-specific treatment program to comprehensive insurance under the Affordable Care Act (ACA) on the physical, mental, and prostate cancer-related health of poor, previously uninsured men. MATERIALS AND METHODS: We assessed general and prostate cancer-specific health-related quality of life (QOL) using the RAND 12-item short form health survey and UCLA Prostate Cancer Index at 3 time points in 24 men transitioning to comprehensive insurance (insured group) relative to 39 men remaining in the prostate cancer program (control group)...
February 6, 2018: Journal of Urology
https://www.readbyqxmd.com/read/29421019/access-to-routine-care-and-risks-for-30-day-readmission-in-patients-with-cardiovascular-disease
#16
Matthew E Dupre, Hanzhang Xu, Bradi B Granger, Scott M Lynch, Alicia Nelson, Erik Churchill, Janese M Willis, Lesley H Curtis, Eric D Peterson
BACKGROUND: Studies have shown that access to routine medical care is associated with the prevention, diagnosis, and treatment of chronic diseases. However, studies have not examined whether patient-reported difficulties in access to care are associated with rehospitalization in patients with cardiovascular disease. METHODS: Electronic medical records and a standardized survey were used to examine cardiovascular patients admitted to a large medical center from January 1, 2015 through January 10, 2017 (n=520)...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29415338/a-statewide-program-providing-colorectal-cancer-screening-to-the-uninsured-of-south-carolina
#17
Jan M Eberth, Annie Thibault, Renay Caldwell, Michele J Josey, Beidi Qiang, Edsel Peña, Delecia LaFrance, Franklin G Berger
BACKGROUND: Cancer screening rates are lowest in those without insurance or a regular provider. Since 2008, the Colorectal Cancer Prevention Network (CCPN) has provided open access colonoscopy to uninsured residents of South Carolina through established, statewide partnerships and patient navigation. Herein, we describe the structure, implementation, and clinical outcomes of this program. METHODS: The CCPN provides access to colonoscopy screening at no cost to uninsured, asymptomatic patients aged 50-64 years (African Americans age 45-64 years are eligible) who live at or below 150% of the poverty line and seek medical care in free medical clinics, federally qualified health centers, or hospital-based indigent practices in South Carolina...
February 7, 2018: Cancer
https://www.readbyqxmd.com/read/29412043/acute-crisis-care-for-patients-with-mental-health-crises-initial-assessment-of-an-innovative-prehospital-alternative-destination-program-in-north-carolina
#18
Jamie O Creed, Julianne M Cyr, Hillary Owino, Shannen E Box, Mia Ives-Rublee, Brian B Sheitman, Beat D Steiner, Jefferson G Williams, Michael W Bachman, Jose G Cabanas, J Brent Myers, Seth W Glickman
OBJECTIVE: Emergency Departments (ED) are overburdened with patients experiencing acute mental health crises. Pre-hospital transport by Emergency Medical Services (EMS) to community mental health and substance abuse treatment facilities could reduce ED utilization and costs. Our objective was to describe characteristics, treatment, and outcomes of acute mental health crises patients who were transported by EMS to an acute crisis unit at WakeBrook, a North Carolina community mental health center...
February 7, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29408018/cigarette-smoking-in-persons-living-with-hepatitis-c-the-national-health-and-nutrition-examination-survey-nhanes-1999-2014
#19
Ryung S Kim, Andrea H Weinberger, Geetanjali Chander, Mark S Sulkowski, Brianna Norton, Jonathan Shuter
BACKGROUND: Cigarette smoking is common in persons living with hepatitis C (hepatitis C+), but national statistics on this harmful practice are lacking. A better understanding of smoking behaviors in hepatitis C+ individuals may help in the development of targeted treatment strategies. METHODS: We extracted data from the National Health and Nutrition Examination Survey (NHANES) between 1999-2014. Hepatitis C+ were compared to hepatitis C- adults in the entire sample and in the subset of current smokers...
January 30, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29403021/use-of-hematopoietic-cell-transplantation-in-younger-patients-with-acute-myeloid-leukemia-a-national-cancer-database-study
#20
Vijaya Raj Bhatt, Baojiang Chen, Stephanie J Lee
Younger patients with intermediate or high-risk acute myeloid leukemia (AML) obtain overall survival benefit from the upfront use of hematopoietic cell transplantation (HCT). We queried the National Cancer Database to study 19,897 younger patients (18-60 years) with intermediate or high-risk AML reported between 2003-2012. Multivariable logistic regression analysis was performed to identify variables associated with the utilization of HCT. Approximately 18.5% of younger patients received HCT as a part of initial therapy...
February 5, 2018: Bone Marrow Transplantation
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